Affordable Health Care: A Personal Story


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I have been in the workforce thirty seven years.  The last time I had health insurance offered by my employer was 1989. I was a union worker and my monthly premiums were $25, with a $5 co-pay for doctor visits.  I had to leave that job because they went out of business. All my other places of employment involved food service and none of them offered health insurance.

Fast forward to 2008 and the economy in Northern California tanked much like the rest of the nation. My hours were slashed and working as a food server that is not good, so we moved to Southern California on the recommendation of a friend. We were told that there were plenty of restaurants in Orange County and it would be easy to find a job.

It probably is easy but not for someone over the age of fifty. How many people do you see working in restaurants older than thirty? So I ended up working three part time jobs and my husband found a full time job. None of these places offered health insurance either and we could not afford to buy a policy on our own.

We were both lucky and hardly ever got sick until December 25th 2010. I hadn’t been feeling right for a few months, but was seeing a doctor who was treating me for hemorrhoids and IBS.  I woke up that December morning and I knew there was something seriously wrong with me. We went to emergency and I worried the whole time how we would pay for the visit.

To make a long story short, I was diagnosed with cancer.  I was hospitalized immediately and given blood transfusions. I stayed the first time ten days. I still have the hospital bill; $247,000.  Luckily, I qualified for MediCal because I couldn’t work. My treatments lasted ten months, which is relatively short compared to a lot of cancer patients. I am cancer free and grateful that MediCal accepted me, however I still have ongoing complications from chemotherapy and radiation. I have a permanent colostomy bag.  The monthly cost of ostomy supplies run me $150 a month — and that’s only if they last as long as they are supposed to.

I qualified for Social Security as well, not Social Security Disability because our assets were more than $3,000. Our car was worth $5,000 so I did not qualify for that. As soon as my Socially Security checks started my share of cost changed dramatically to $800 a month. Our gross income is $2500 a month and according to some chart (that has not been reviewed since 1997) that MediCal uses to determine eligibility, we are now middle class.

I would like to know whose great idea it was to determine eligibility on money that people do not have. Every month we lose about 35% of income to various taxes. We do not live off $2500 a month.

When someone is diagnosed with cancer they see specialists and specialists are expensive. A typical office visit averages around $300 and that’s if the doctor doesn’t do anything. I also have a port in my chest that needs to be flushed every six weeks. That costs $150 a visit.  Any medications or doctor visits I need are not covered by MediCal until I reach my $800 monthly share of cost.  Luckily, I do not receive cancer treatments anymore but I use my credit card to pay for my supplies, flushes, semi-annual scans and doctor checkups.  The problem is coming up with the money to pay more than the minimum balance each month so I can continue getting medical services, and not max out my credit card.

Senator Lou Correa is my Representative, so I decided to pay him a visit to help me appeal the MediCal decision. I must have had a brain fart when I decided to ask him for help because he voted “no” to single payer healthcare, claiming that healthcare is not a priority in his district. That’s funny because 25% of his constituents don’t have health insurance. I met with two of his staff who seemed interested in helping me (I emphasize the word seemed) but after a couple of weeks they no longer returned my phone calls.  But his staff member, Arthur Sandoval, was kind enough to remind me I am not the only one with health insurance issues. Thanks Art I feel better now! I am so glad to hear my representative, Lou Correa, doesn’t think healthcare is a priority.

I spent hours on the computer and the phone trying to find a better insurance. I was given the website California PCIP Insurance,  http://www.pcip.ca.gov/Home/default.aspx  and was told they had inexpensive health insurance for people with pre-existing conditions, so I checked them out. I don’t know who actually decides what qualifies as inexpensive or affordable health insurance; it must be the same guy that thinks people live off their gross incomes. The group I fell in too offers insurance premiums for $1250 a month, plus high deductibles and co-pays. The waiting list is at least a year. These policies are offered by the private insurance carriers. It works similar to a builder getting permission to build homes in an area but must allow 10% of the housing to be low income.

This brings me to the reason why I am writing about my personal experience with healthcare and insurance. The Supreme decided that mandating its citizens to buy health insurance is Constitutional. They conveniently changed the word penalty to tax so people would feel better when they were getting ripped off at the end of the year. I know another reason why they call it tax, because the IRS can garnish someone’s wages that refuses to pay this tax and for those who cannot afford the tax (which seems to be rising hourly since the decision from 1% to $1,000 a year) can make payments and get charged 30% interest rate.

Millions of people are out of work, with no end in sight, and many others are struggling to make rent or mortgage payments. Exactly where do they get the extra money to buy health insurance, or the new tax? This is clearly a tax on the working poor and middle class. The wealthy can afford the luxury of health insurance and yes, I am calling it a luxury. I visit cancer patients each week and you know the number one thing they worry most about? Bankruptcy! And these people have insurance, but when they got diagnosed their premiums went up. Insurance only covers 80% of medical expenses, so when someone is faced with a $247,000 hospital bill they have to come up with the remaining 20%. People with life threatening illnesses should not have to be worrying about losing their homes or life savings to pay for medical bills. Single payer is the only way to ensure everyone is covered, but because of this ruling it will not be part of the conversation anymore.

I turned off the news yesterday because of all the cheers from Democrats getting the Affordable Healthcare Act pushed through. The only winners I see are the insurance companies. They just got a big fat bonus from our friends in Washington. Today I heard a senator actually say that it is up to individuals to take care of their own healthcare needs, not government. Requiring everyone to buy insurance will take care of that. He had the nerve to say that the reason people don’t have health insurance is because they choose not to. Is he kidding? At $1250 a month it’s either insurance or sleeping indoors. I like sleeping indoors. But for now I do have insurance, it’s horrible but I have something. What about other people? I know darned well how those eligibility requirements work, but the average person doesn’t. They will be in for sticker shock! Yes, people with pre-existing conditions (there are at least 200 of them), http://www.vaughns-1-pagers.com/medicine/pre-existing-conditions.htm/  will get insurance, but at what cost? $1250 a month?  $2,000 a month? There is nothing stopping the private/for profit insurance companies from raising rates astronomically. And you better believe they will. Their stockholders will demand it.

The Huffington Post even reported this morning that the new mandate does not mean insurance premiums will go down. I am betting they go up and up and up. The worst thing that will happen is that their customers will drop their policies and then the government gets more tax money.

This new healthcare plan is not what it appears to be. Insurance companies will pay attorneys big money to figure out loopholes around the new law. In the meantime people will continue to get sick and require expensive lifesaving treatments, and they won’t realize until it’s too late exactly what they got for their money because the language in the policy requires an expert in double-speak to decode the darn thing, just like the bill our representatives write to make our laws.

[Inge, who previously wrote for the Orange Juice Blog as "Mika Wallace," will be reporting for us live from the World Trade Negotiations in San Diego next week! - ed]


About Inge

Cancer survivor. Healthy organic food coach. Public speaker. If you have a story you want told, contact me at iscott.orangejuiceblog@gmail.com/